1. This Chapter examines medicine consumption by volume within the
non-hospital sector. Usage patterns across 84 countries in all income categories and with a
variety of different health-care systems are described.

2. Consumption has grown in countries of all income categories. The
percentage growth is higher in low-income countries than high-income countries, although in
absolute terms the picture is reversed.

3. Medicines to treat chronic disease are taking a larger proportion of total
volume in the non-hospital sector. Projections indicate that chronic disease medicine
volumes will need to increase dramatically if access is to be provided to those who need
these medicines.

4. Usage of medicines included on the WHO Model List of Essential Medicines
is similar across countries of all income categories, at about 25–35%. Higher country
income is not associated with different use of the Model List products, and
out-of-pocket expenditure is not necessarily associated with lower rates.

5. There is considerable variation in the share of original and licensed
brand products both within and across product categories and countries as compared with other brands and unbranded products. This variation may represent an opportunity for policy intervention to encourage a shift in consumption to the generally cheaper unbranded categories of products.

6. Analysis of consumption is complicated by the diversity of databases and
classification systems. While the different systems can be viewed as being complementary, consumption patterns, and the impact of pharmaceutical policy in aggregate,
could be clearer if data from the public and private sectors were combined. The need for
more comprehensive information is particularly acute in low-income countries.